A Disease of Special Knowledge

My line of work has brought me in contact with more than a few schizophrenics over the years, both as story subjects and as correspondents. I’ve become quite familiar with the seemingly impenetrable logic by which such people try to make sense of the world, and how their off-tangent worldviews occasionally lead to the commission of terrible acts. I have great sympathy for those who are cast adrift in their own delusions; as the schizophrenic mathematician John Nash once observed, the men and women who suffer from this disease do not view themselves as ill, but rather as lucky souls who’ve been blessed with “special knowledge” about the world.

I though of Nash’s quote while trying to process Saturday’s tragic events in Tuscon, which were obviously the handiwork of a schizophrenic young man. Vast seas of digital ink have been spilled in an effort to identify Jared Lee Loughner’s politics, but I think that’s ultimately a mug’s game. He appears to have much less in common with past political assassins than he does with Nathan Gale, the schizophrenic former Marine who killed the great guitarist Dimebag Darrell Abbott in 2004. The motives of both killers will never truly make sense to the rest of us, because we will never have first-hand access to the deluded realms in which these two men lived. Gale, for example, had a fixation on Abbott, to the point that he believed that the musician was stealing lyrics out of his brain. My hunch is that Loughner’s motives, if they’re ever wholly revealed, will be similarly nonsensical—though not, of course, to him.

Rather than sift through Loughner’s screeds in search of political clarity, my first research impulse was to look into the historical prevalence of schizophrenia. I wondered whether the Tuscon tragedy was a harbinger of things to come, a sign that incidents of schizophrenia-related violence might soon be on the ascent. But my hypothesis looks to have been way off base; diagnoses of schizophrenia have actually been plummeting in the Western world, despite greater awareness of the disease’s symptoms. This paper makes the argument that better care before and during childbirth has made a huge statistical difference:

Obstetric complications are related to the subsequent development of schizophrenia, the risk for people born with complications being two to three times greater than that for people born without. Complications of delivery, rather than of pregnancy, are more likely to occur with increased frequency in schizophrenia samples; and oxygen deprivation, especially owing to prolonged labor, appears to be the common denominator among these complications. In four studies cited by McNeil (1988), prolonged labor occurred in 17 to 40 percent of schizophrenia samples compared with 8 to 19 percent of control subjects.

Yet schizophrenia is an ancient disease, and one we’re unlikely to ever excise through mere obstetric caution. Attention must be paid, then, to those most at risk for the malady—and, curiously, that often means migrants in big cities:

A coherent and consistent body of research has emerged in recent years demonstrating that migrants have an increased risk of schizophrenia. Two recent systematic reviews have confirmed that migrants have a significantly increased risk of developing schizophrenia (approximately
a three- to fivefold risk ratio)…

Several high-quality studies have indicated that those born in cities have approximately a twofold increased risk of developing schizophrenia, compared to those born in rural regions. As a large proportion of individuals
in the developed world are born in cities, the population-attributable fraction for this exposure is substantial (about 30%). A systematic review recently
reported that those living in cities also had significantly higher incidence rates of schizophrenia compared to those living in mixed urban–rural sites.

The bottom line is that someone needed to step in and get Loughner the treatment he so obviously needed. But as was the case with Nathan Gale, no one seemed to recognize that a man who claims to be in possession of “special knowledge” can become a monster—even though, in his own eyes, he is simply acting as nature intended.

Have you read “The Origin of Consciousness in the Breakdown of the Bicameral Mind?”. I admit I haven’t but Jaynes reportedly has interesting take on auditory hallucinations of schizophrenics. My understanding of his theory, of consciousness as a cultural construct would mean a continuing decline of schizophrenia. Interesting that there is a connection with urban living.

@Captured Shadow: Strangely, another risk factor seems to be month of a person’s birth. Not as big of a factor as urban living or (more significantly) migration status, but it does appear to make a difference. People born in winter have higher incidence of schizophrenia. Haven’t yet come across a good hypothesis as to why that’s the case though.

Yes.
Run an Ngram on schizophrenia,autism to see something interesting.
Also, have you read the “double-bind” origin of schizophrenia? Environmental (social) blocking of early sense-making seems to have a lot to do with it.

@monkeyball: Thanks a mil for the links. I have a vague memory of this research being reported, but will have to go back and read the source material. I’ve definitely heard the virus theory numerous times, though I don’t quite grok the mechanics.